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https://www.readbyqxmd.com/read/28404155/survival-outcomes-following-laparoscopic-versus-open-d3-dissection-for-stage-ii-or-iii-colon-cancer-jcog0404-a-phase-3-randomised-controlled-trial
#1
Seigo Kitano, Masafumi Inomata, Junki Mizusawa, Hiroshi Katayama, Masahiko Watanabe, Seiichiro Yamamoto, Masaaki Ito, Shuji Saito, Shoichi Fujii, Fumio Konishi, Yoshihisa Saida, Hirotoshi Hasegawa, Tomonori Akagi, Kenichi Sugihara, Takashi Yamaguchi, Tadahiko Masaki, Yosuke Fukunaga, Kohei Murata, Masazumi Okajima, Yoshihiro Moriya, Yasuhiro Shimada
BACKGROUND: Although benefits of laparoscopic surgery compared with open surgery have been suggested, the long-term survival of patients undergoing laparoscopic surgery for colon cancer requiring Japanese D3 dissection remains unclear. We did a randomised controlled trial to establish non-inferiority of laparoscopic surgery to open surgery. METHODS: We did an open-label, multi-institutional, randomised, two-arm phase 3 trial in 30 hospitals in Japan. Patients aged 20-75 years who had histologically proven colon cancer; tumours located in the caecum or ascending, sigmoid, or rectosigmoid colon; T3 or deeper lesions without involvement of other organs, node stages N0-2, and metastasis stage M0; and tumour size of 8 cm or smaller were included...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28400101/overcoming-the-exacerbating-effects-of-ranitidine-on-nsaid-induced-small-intestinal-toxicity-with-quercetin-providing-a-complete-gi-solution
#2
Devendra Pratap Singh, Swapnil P Borse, Manish Nivsarkar
There is a need to find/discover novel leads to treat complex and/or multi-factorial-pathogenic disease(s) like Nonsteroidal anti-inflammatory drugs (NSAID)-induced gastroenteropathy or gastrointestinal (GI) toxicity as it has emerged as an important medical and socioeconomic problem. There is no approved therapeutic strategy to prevent NSAID-induced small intestinal toxicity and highly effective gastro-protective drugs such as ranitidine hydrochloride (RAN) exacerbate it. In this purview, the multi target drug discovery approach (MTDD), combination approach and hit to lead strategies based on the foundation of ethnopharmacology and/or reverse pharmacology holds strong potential...
April 8, 2017: Chemico-biological Interactions
https://www.readbyqxmd.com/read/28394065/patients-of-doctors-further-from-medical-school-graduation-have-poorer-outcomes
#3
John J Norcini, John R Boulet, Amy Opalek, W Dale Dauphinee
CONTEXT: There is an apparent contradiction between the findings of studies indicating that patient outcomes are better when physicians have a greater volume of practice and those that find outcomes to be worse with increased time since training, which implies greater volume. OBJECTIVES: This study was designed to estimate the adjusted relationships between physicians' characteristics, including recent practice volume and time since medical school graduation, and patient outcomes...
May 2017: Medical Education
https://www.readbyqxmd.com/read/28343975/trastuzumab-emtansine-versus-taxane-use-for-previously-treated-her2-positive-locally-advanced-or-metastatic-gastric-or-gastro-oesophageal-junction-adenocarcinoma-gatsby-an-international-randomised-open-label-adaptive-phase-2-3-study
#4
Peter C Thuss-Patience, Manish A Shah, Atsushi Ohtsu, Eric Van Cutsem, Jaffer A Ajani, Hugo Castro, Wasat Mansoor, Hyun Cheol Chung, Gyorgy Bodoky, Kohei Shitara, Gail D Lewis Phillips, Tina van der Horst, Marie-Laurence Harle-Yge, Betsy L Althaus, Yoon-Koo Kang
BACKGROUND: Although trastuzumab plus chemotherapy is the standard of care for first-line treatment of HER2-positive advanced gastric cancer, there is no established therapy in the second-line setting. In GATSBY, we examined the efficacy and tolerability of trastuzumab emtansine in patients previously treated for HER2-positive advanced gastric cancer (unresectable, locally advanced, or metastatic gastric cancer, including adenocarcinoma of the gastro-oesophageal junction). METHODS: This is the final analysis from GATSBY, a randomised, open-label, adaptive, phase 2/3 study, done at 107 centres (28 countries worldwide)...
March 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28331567/what-is-the-best-algorithm-for-investigation-of-acute-lower-gastrointestinal-haemorrhage
#5
Ainkaran Santhirasekaram, Sherif Latif, Easha Arooj, Kamran Rostami, Sauid Ishaq
An 81-year-old male presented with multiple episode of severe PR bleeding over 2 days. CTA done prior to catheter angiography that enabled successful intervention. This case emphasises the importance of CTA prior to catheter angiography in acute LGIB.
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28331018/strongyloides-hyperinfection-syndrome-in-an-immunocompetent-host-resulting-in-bandemia-and-death
#6
Aung Myint, Courtney Chapman, Isabel Almira-Suarez, Nupur Mehta
Strongyloides stercoralis infection is usually asymptomatic but can result in a hyperinfection syndrome, most commonly triggered by acquired or iatrogenic immunosuppression. Here, we present a case of a man aged 60 years originally from a strongyloides endemic area with a medical history of alcohol abuse who presents with strongyloides hyperinfection syndrome (SHS) complicated by partial small bowel obstruction, pulmonary haemorrhage, large bandemia without eosinophilia and cardiac arrest resulting in death...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28300870/effectiveness-and-safety-of-apixaban-versus-warfarin-in-non-valvular-atrial-fibrillation-patients-in-real-world-clinical-practice-a-propensity-matched-analysis-of-76-940-patients
#7
Xiaoyan Li, Steve Deitelzweig, Allison Keshishian, Melissa Hamilton, Ruslan Horblyuk, Kiran Gupta, Xuemei Luo, Jack Mardekian, Keith Friend, Anagha Nadkarni, Xianying Pan, Gregory Y H Lip
The ARISTOTLE trial showed a risk reduction of stroke/systemic embolism (SE) and major bleeding in non-valvular atrial fibrillation (NVAF) patients treated with apixaban compared to warfarin. This retrospective study used four large US claims databases (MarketScan, PharMetrics, Optum, and Humana) of NVAF patients newly initiating apixaban or warfarin from January 1, 2013 to September 30, 2015. After 1:1 warfarin-apixaban propensity score matching (PSM) within each database, the resulting patient records were pooled...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28276744/the-cohen-hoberman-inventory-of-physical-symptoms-factor-structure-and-preliminary-tests-of-reliability-and-validity-in-the-general-population
#8
Sarah F Allen, Mark A Wetherell, Michael A Smith
OBJECTIVE: The present study aimed to investigate the factor structure and psychometric properties of the Cohen-Hoberman inventory of physical symptoms (CHIPS). Construct and discriminant validity were examined by assessing associations between factors and subjective health complaints (SHC) inventory subscales in addition to measures of pain sensitivity, perceived stress and psychological distress. DESIGN: A cross-sectional online survey was conducted with 535 healthy individuals from the general population (80...
February 17, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28272736/reintroduction-of-anti-thrombotic-therapy-after-a-gastrointestinal-haemorrhage-if-and-when
#9
REVIEW
Martin J Scott, Andrew Veitch, Jecko Thachil
Gastrointestinal haemorrhage is a common clinical scenario and, in those using antithrombotic agents, the risk is significantly increased. Management of these patients, in terms of initial resuscitation is well established and numerous guidelines exist in this area. However, few studies have addressed the subsequent dilemma of if and when antithrombotic agents should be reintroduced. Consequently, practice is variable and not necessarily evidenced-based. Overall, for patients that are either anticoagulated or using antiplatelet drugs for secondary prophylaxis, there is a clear benefit to restarting these agents...
March 8, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28255142/upper-gastrointestinal-haemorrhage-in-severe-dengue-to-scope-or-not-to-scope
#10
C H Lim, N H S Benjamin, F K Kan
Upper gastrointestinal haemorrhage (UGIH) in severe dengue represents a clinical dilemma in term of management. The recommended treatment in dengue with UGIH involves blood product transfusion support and proton pump inhibitor (PPI) infusion. Despite being the mainstay of treatment in non-dengue UGIH, the role of endoscopic haemostatic intervention in severe dengue remains controversial. In the present report, we present a case of severe dengue complicated with upper gastrointestinal haemorrhage successfully underwent early therapeutic endoscopic intervention in a district hospital...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28252348/an-unusual-haemorrhagic-complication-of-an-anastomotic-leak-and-a-novel-method-of-controlling-the-haemorrhage
#11
S Martin, A Armstrong
Introduction Restorative proctocolectomy (RP) is undertaken for patients with familial adenomatous polyposis (FAP) and ulcerative colitis, but is associated with a risk of anastomotic leak. Case history A 20-year-old male with a family history of FAP had a RP with a double-stapled J-pouch and covering loop ileostomy. At ileostomy reversal 21 months later, he presented with significant anal bleeding. He proceeded to theatre for endoscopy. Pouchoscopy showed a pouch full of blood and a foreign object trapped in a diverticulum...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28238470/fatal-salmonellosis-in-captive-maras-dolichotis-patagonum-caused-by-salmonella-enteritidis
#12
S Nakamura, Y Yoshimura, H Hayashidani, T Iwata, S Iseda, Y Une
We report epidemic occurrences of fatal salmonellosis caused by Salmonella Enteritidis in captive maras (Dolichotis patagonum) in a zoological garden in Japan. The deaths were sudden or followed a peracute course within a few hours of the first observations of clinical abnormalities. Gross lesions included haemorrhages in the subcutis and skeletal muscles, liver, spleen, lung, heart and gastrointestinal tract. Microscopically, there were haemorrhagic and necrotizing lesions with gram-negative bacilli in the liver, spleen, small intestine and Peyer's patches...
February 23, 2017: Journal of Comparative Pathology
https://www.readbyqxmd.com/read/28223092/obestatin-improves-oxidative-brain-damage-and-memory-dysfunction-in-rats-induced-with-an-epileptic-seizure
#13
Türkan Koyuncuoğlu, Caner Vızdıklar, Doğan Üren, Hakan Yılmaz, Çağan Yıldırım, Sefa Semih Atal, Dilek Akakın, Elif Kervancıoğlu Demirci, Meral Yüksel, Berrak Ç Yeğen
Obestatin was shown to alleviate renal, gastrointestinal and haemorrhage-induced brain injury in rats. In order to investigate the neuroprotective effects of obestatin on seizure-induced oxidative brain injury, an epileptic seizure was induced with a single intraperitoneal (i.p.) dose of pentylenetetrazole (PTZ, 45mg/kg) in male Wistar rats. Thirty minutes before the PTZ injection, rats were treated with either saline or obestatin (1μg/kg, i.p.). Seizure was video-taped and then evaluated by using Racine's scoring (0-5)...
February 20, 2017: Peptides
https://www.readbyqxmd.com/read/28155296/paraquat-intoxication-and-associated-pathological-findings-in-three-dogs-in-south-africa
#14
June H Williams, Zandri Whitehead, Erna Van Wilpe
Paraquat is a bipyridylium non-selective contact herbicide commonly used worldwide. When ingestion occurs by humans and animals either accidentally, intentionally or maliciously, paraquat selectively accumulates in the lungs resulting in the production of oxygen-free radicals, causing membrane damage and cell death. Intoxicated subjects typically show progressive and fatal pulmonary haemorrhage, collapse and oedema. In individuals surviving the acute phase, pulmonary fibrosis develops. Gastrointestinal-, renal- and central nervous system clinical signs may also occur...
November 9, 2016: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/28133740/toxicity-of-metronomic-cyclophosphamide-chemotherapy-in-a-uk-population-of-cancer-bearing-dogs-a-retrospective-study
#15
A Harper, L Blackwood
OBJECTIVES: The objective of this study was to assess the incidence of toxicity in a group of cancer-bearing dogs treated with metronomic chemotherapy. MATERIALS AND METHODS: Retrospective review of dogs treated with metronomic doses of cyclophosphamide: between 5 and 15 mg/m(2) /day or every other day for treatment of neoplasia. RESULTS: Of the 65 dogs included, there were signs of, mostly mild, toxicity in 32 (49%). The most common toxicities were sterile haemorrhagic cystitis (n=16) and gastrointestinal disorders (n=12)...
January 30, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28119348/a-pragmatic-approach-to-vasculitis-in-the-gastrointestinal-tract
#16
REVIEW
Runjan Chetty, Stefano Serra
Although vasculitis involving the gastrointestinal tract (GIT) is an uncommon occurrence, occasionally vasculitis can present as haemorrhagic infarction or ischaemia for which a length of bowel is removed. Invariably, the appropriate clinical history is not forthcoming, or vasculitis is not clinically suspected. The purpose of this overview is to provide the practising gastrointestinal (GI) pathologist with a framework to recognise and diagnose vasculitides within the GIT. The classification may be approached by aetiological agent or size of vessel involved; an international consensus group now favours the latter approach...
January 24, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28079233/suspected-blood-indicator-in-capsule-endoscopy-a-valuable-tool-for-gastrointestinal-bleeding-diagnosis
#17
Pedro Boal Carvalho, Joana Magalhães, Francisca Dias DE Castro, Sara Monteiro, Bruno Rosa, Maria João Moreira, José Cotter
BACKGROUND: Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI) is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy. OBJECTIVE: - We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding. Methods - Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28071818/safety-profile-of-the-direct-oral-anticoagulants-an-analysis-of-the-who-database-of-adverse-drug-reactions
#18
Luca Monaco, Chiara Biagi, Valentino Conti, Mauro Melis, Monia Donati, Mauro Venegoni, Alberto Vaccheri, Domenico Motola
AIM: Direct oral anticoagulants (DOACs) have shown non-inferiority to warfarin for stroke prevention in non-valvular atrial fibrillation (AF) and a more promising safety profile. Unanswered safety aspects remain to addressed and available evidence on the risk associated with these drugs are conflicting. In order to contribute to the debate on their safety profile, we conducted a comparative analysis of the reports of suspected adverse drug reactions (ADRs) associated with DOACs in VigiBase...
January 10, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28051764/the-use-of-fibrin-sealant-during-non-emergency-surgery-a-systematic-review-of-evidence-of-benefits-and-harms
#19
Steven J Edwards, Fay Crawford, Michelle Helena van Velthoven, Andrea Berardi, George Osei-Assibey, Mariana Bacelar, Fatima Salih, Victoria Wakefield
BACKGROUND: Fibrin sealants are used in different types of surgery to prevent the accumulation of post-operative fluid (seroma) or blood (haematoma) or to arrest haemorrhage (bleeding). However, there is uncertainty around the benefits and harms of fibrin sealant use. OBJECTIVES: To systematically review the evidence on the benefits and harms of fibrin sealants in non-emergency surgery in adults. DATA SOURCES: Electronic databases [MEDLINE, EMBASE and The Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and the Cochrane Central Register of Controlled Trials)] were searched from inception to May 2015...
December 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28051053/simultaneous-occurrence-of-intussusception-and-duodenal-haematoma-in-a-patient-with-glanzmann-s-thrombasthenia
#20
Iftikhar Ahmad Jan, Saif Khalfan AlKaabi, Awadh AlMughadam, D Sreenivas Murthy, Basmah AlHamoudi
Glanzmann's thrombasthenia (GT) is a rare autosomal recessive disorder in which the platelets have anomalies of fibrinogen receptors causing bleeding tendencies. The disease usually presents with mucosal bleeding, petechial haemorrhages or gastrointestinal (GI) bleeding. Only sporadic cases of intussusception or duodenal haematoma have been reported with GT. We present a case of 5-year-old girl admitted with non-bilious vomiting, watery diarrhoea and abdominal pain. She is a known patient of Glanzmann's thrombasthenia...
October 2016: African Journal of Paediatric Surgery: AJPS
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